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• iii iiiiiiiiiiiuiii • <br />ANNUAL REPORT <br />PERMTI'TEE NAME: Fremont County <br />PERMIT NO.: M-94-118 <br />OPERATION NAME: Phantom Canyon Pit <br />ANNNERSARY DATE: August 08, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Teller <br />.•~~ ~ ,® <br />`"~ DECEIVED <br />AUG 0 9 ~gg9 <br />. - ~ or wiineray & Geology <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this <br />annual report. Please note that an adequately labeled map that clearly delineates and <br />includes dre above elements may suffice for n written report. <br />Please type or print the curcent contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: ~G.hW tiifi S, ~L.co Company: ~~.y`2,x'1>=, ~X~tt <br />Address: ~~C2.x~C 33S Phone No.: (~~°~ ) 94Z-4t ~S <br />~ot-oP A>n . Cry $i2Z?i Fax No.: ( ?~1°l ) °a4Z-4.1_"8 <br />h` there are additional comments and/or information [hat should be provided to the Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />written report. <br />Signature of Corporate Officer, or Owner Date <br />/NSTRUCT/ONS ON BACK <br />